Our Summary

This study aimed to find out if it’s safe and effective to perform two procedures at once: fixing a type of hernia that’s common in obese people (called a para-oesophageal hernia), and placing a laparoscopic adjustable gastric band to help with weight loss.

The researchers looked at 114 patients who had both procedures done at the same time and compared them to a similar group who only had the gastric banding. They tracked weight loss and any complications, and also asked patients about their symptoms, how satisfied they were with the surgery, and how full they felt after meals.

After about five years, the weight loss was similar in both groups, and there wasn’t a significant difference in the rate of complications or in how the patients felt.

The study concluded that it’s safe and effective to do both procedures at the same time. This could be a good option for obese patients with this type of hernia.

FAQs

  1. Is it safe to perform a para-oesophageal hernia repair and a laparoscopic adjustable gastric band placement at the same time?
  2. Was there any difference in weight loss and complications between patients who had both procedures done at the same time and those who only had the gastric banding?
  3. What was the outcome of the study regarding performing both para-oesophageal hernia repair and laparoscopic adjustable gastric band placement simultaneously?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hiatal hernia repair is to follow post-operative care instructions carefully, including avoiding heavy lifting, sticking to a soft diet, and taking prescribed medications as directed. It’s also important to attend follow-up appointments to monitor healing and address any concerns.

Suitable For

Typically, patients recommended for hiatal hernia repair are those who have symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation, and acid reflux that do not improve with medication or lifestyle changes. Additionally, patients with complications such as Barrett’s esophagus or strictures may also be recommended for hiatal hernia repair. In this study, obese patients with para-oesophageal hernias were specifically recommended for the combined procedure of hiatal hernia repair and laparoscopic adjustable gastric band placement.

Timeline

Before the hiatal hernia repair:

  • Patient experiences symptoms such as heartburn, chest pain, difficulty swallowing, or regurgitation
  • Patient undergoes diagnostic tests such as endoscopy or barium swallow to confirm the presence of a hiatal hernia
  • Patient may be advised to make lifestyle changes such as losing weight, avoiding trigger foods, or elevating the head of the bed
  • If symptoms persist or worsen, the patient may be recommended for surgery to repair the hiatal hernia

After the hiatal hernia repair:

  • Patient undergoes laparoscopic surgery to repair the hiatal hernia, which involves pulling the stomach back into place and closing the opening in the diaphragm
  • Recovery time is typically 2-6 weeks, during which the patient may experience pain, bloating, or difficulty swallowing
  • Patient may be advised to follow a soft diet and avoid heavy lifting or strenuous activity during the recovery period
  • After the recovery period, the patient should experience relief from symptoms such as heartburn and chest pain, and may be able to resume normal activities and diet
  • Long-term follow-up may be recommended to monitor for any recurrence of the hiatal hernia and to assess the overall success of the surgery

What to Ask Your Doctor

Some questions a patient should ask their doctor about hiatal hernia repair include:

  1. What type of hiatal hernia repair procedure do you recommend for me?
  2. What are the potential risks and complications associated with the procedure?
  3. How long is the recovery period after hiatal hernia repair surgery?
  4. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  5. How successful is the procedure in relieving symptoms of acid reflux and heartburn?
  6. Are there any alternative treatment options for hiatal hernia that I should consider?
  7. How experienced are you in performing hiatal hernia repair surgeries?
  8. Will I need to undergo any additional tests or evaluations before the surgery?
  9. What can I expect in terms of long-term outcomes and potential complications after the surgery?
  10. Are there any specific post-operative instructions or precautions I should follow to ensure a successful recovery?

Reference

Authors: Long AJ, Burton PR, Laurie CP, Anderson ML, Hebbard GS, O’Brien PE, Brown WA. Journal: Obes Surg. 2016 May;26(5):1090-6. doi: 10.1007/s11695-015-1881-6. PMID: 26452483